Can tigecycline (generic name) cause diarrhea?

From the Guidelines

Yes, tigecycline can cause diarrhea, as it is one of the most common side effects of this antibiotic, occurring in approximately 12-27% of patients who receive it. Tigecycline is a glycylcycline antibiotic used to treat complicated skin infections, intra-abdominal infections, and community-acquired bacterial pneumonia. Like many antibiotics, tigecycline can disrupt the normal balance of bacteria in the intestines, leading to gastrointestinal disturbances including diarrhea. In some cases, this disruption can allow overgrowth of Clostridioides difficile (C. diff), potentially causing C. diff-associated diarrhea, which can be severe.

Key Points to Consider

• Patients taking tigecycline should stay hydrated and contact their healthcare provider if they experience severe, persistent, or bloody diarrhea, especially if accompanied by fever or abdominal pain.
• These symptoms could indicate a more serious condition requiring prompt medical attention.
• Most cases of antibiotic-associated diarrhea resolve after completing the antibiotic course, but some may require specific treatment.
• The use of tigecycline should be based on its approved indications and dosing, considering its limitations in treating certain infections, such as those caused by Acinetobacter baumannii, as noted in studies 1.
• High-dose regimens of tigecycline may be considered for certain infections, such as hospital-acquired pneumonia (HAP) or ventilator-associated pneumonia (VAP), as suggested by guidelines and studies 1.

Clinical Considerations

• Tigecycline's efficacy and safety profile should be considered in the context of the infection being treated and the patient's overall clinical condition.
• Combination therapy with other antimicrobials may be necessary for severe or complicated infections, as indicated by guidelines and studies 1.
• Monitoring for adverse events, including diarrhea, and adjusting treatment as necessary is crucial for optimizing patient outcomes.

Evidence Summary

The evidence regarding tigecycline's potential to cause diarrhea is based on its mechanism of action as an antibiotic and reports from clinical studies and guidelines 1. While the primary focus of these studies and guidelines is on the treatment of various infections, the common side effect of diarrhea is consistently noted across different patient populations and infection types.

From the FDA Drug Label

1. 8 Clostridium difficile -Associated Diarrhea Clostridium difficile associated diarrhea (CDAD) has been reported with use of nearly all antibacterial agents, including tigecycline, and may range in severity from mild diarrhea to fatal colitis.

17 PATIENT COUNSELING INFORMATION Advise patients, their families, or caregivers that diarrhea is a common problem caused by antibacterial drugs. Sometimes, frequent watery or bloody diarrhea may occur and may be a sign of a more serious intestinal infection

Yes, tigecycline can cause diarrhea, including Clostridium difficile-associated diarrhea (CDAD), which can range from mild to fatal colitis 2, 2.

From the Research

Tigecycline and Diarrhea

• Tigecycline, a broad-spectrum antibiotic, has been reported to cause gastrointestinal side effects, including diarrhea 3, 4.
• A study published in 2021 noted that tigecycline may cause nausea, vomiting, and diarrhea, with some patients experiencing elevated serum aminotransferase, especially in critically ill patients 4.
• Another study from 2008 compared the efficacy and safety of tigecycline with vancomycin or linezolid for treatment of serious infections with methicillin-resistant Staphylococcus aureus or vancomycin-resistant enterococci, and found that nausea or vomiting occurred more frequently with tigecycline than with vancomycin, but did not specifically mention diarrhea as a common side effect 5.
• However, a 2021 study on the effectiveness and safety of high-dose tigecycline for the treatment of severe infections found that high-dose tigecycline resulted in better outcomes compared with controls, without increasing adverse events rates, including diarrhea 6.

Adverse Effects of Tigecycline

• The adverse effects of tigecycline, including diarrhea, should be considered when using the antibiotic, and patients should be monitored for symptoms 3, 7.
• If a patient experiences symptoms of diarrhea or other adverse effects, it may be necessary to stop using tigecycline immediately and switch to a different antibiotic 3, 7.